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Tuesday, January 26, 2010

More on allergies

I think I passed out nearing the end of writing the last post. While I haven't documented it officially, about 25-40% (addendum: 50-60%) of my appointments are related to allergies. The dog with a chronic or recurrent otitis (ear infection): primary allergies. Chronic or recurrent pyoderma (skin infection): primary allergies. Chronic or recurrent client kvetching: primary allergies.
If symptoms are classic, and the pet responds favourably to antihistamines, a presumptive diagnosis of allergy can be made (though not a complete diagnosis). If a pet doesn't respond to antihistamines, allergic disease cannot be completely ruled out, as some dogs respond poorly, or not at all, to these medications. This often occurs in cases of food allergies and severe cases of atopic dermatitis.
Again, pets can be atopic or have a food allergy (to keep things simple). They can certainly also have both.
In cases of non-seasonal symptoms (itchy throughout the year), a food elimination trial is indicated. There are a few ways to do this. You can cook for your pet. In this case you must choose a novel source of protein and carbohydrate, i.e., something the pet has never consumed before. This could mean rabbit, horse, ostrich, kangaroo, and other things that completely gross me out. The source of carbohydrate is often either rice or potato. If you don't want the hassle of cooking the meat of these beasts, a prescription diet, made of hydrolyzed protein, can be tried for a minimum of 12 weeks. These foods include, but are not limited to, Purina HA, Medical HP, and Hill's z/d Ultra. Dogs with confirmed food allergies will respond to one of these diets in at least 75% of cases.
If the pet continues to itch after 3 months of a STRICT food-elimination trial, the dog or cat may have concurrent atopy or just atopy with no food allergy. Intradermal skin testing or serum allergy testing would be indicated in this case, with the aim to have the pet desensitized based on the results of the aforementioned tests (desensitization is essentially a process of vaccinating the patient, slowly however, with multiple and frequent injections, to slowly build up antibodies against the offending antigens).
If your dog or cat has chronic and/or recurrent skin problems, talk to your vet about allergic skin disease. Just be very patient as the diagnosis may take a while to elucidate, and the response to therapy may also require time and trials. Just keep the communication up with your vet because he/she needs to know what works, and what doesn't!
Remember, not only allergies cause itchy skin in dogs and cats.

They may be hypoallergenic.

Sunday, January 24, 2010


I honestly don't remember how many times I've written about allergies in dogs and cats (seriously, I don't know if it's once, twice, or more, but I digress...).
At least a quarter of all patients I see have skin problems, the vast majority of them, allergies.
The white or cream-coloured dog trotting in the park with four stained paws (red-brown colour) elicits an easy spot-diagnosis: allergies.
If your dog or cat is constantly licking or munching on her paws, licking her forearms, scratching her armpits and or groin, shaking her head, scratching her ears, munching or licking her behind, or scratching any part of her outer anatomy, she has allergies.
The problem lies when a careful history is not taken. If you can imagine a pyramid, allergies in the vast majority of these cases figures at the top of it. These allergies cause variable itchiness, which in turn very often cause chronic skin and ear infections.
These infections will disappear with treatment, but unfortunately will invariably recur if the top of the pyramid is unknown. These dogs require antihistamines. Plain and simple. There's a whole gamut of them and often (but not always) one or more will work well.
Dogs and cats can be allergic to inhaled allergens (indoor or outdoor allergens), which will cause seasonal symptoms, while they can also have a food allergy (adverse food reaction), which will cause non-seasonal or year-round symptoms.
They can also have contact allergies (to perfumes, plastic, etc). Dogs and cats can also be allergic to traffic jams (oh, no, wait a minute, that's me).
Bottom line: dogs and cats with allergies have itchy skin, and that could mean anywhere on the body. More to come on allergies.

Dalmatian with a primary allergy and a secondary pyoderma (likely also has a dermal yeast infection but I can't tell from here - need the microscope for that one).